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HomeMy WebLinkAboutBuilding Permit #220-15 - 27 SILSBEE ROAD 8/29/2014 i Of VIORT01 q BUILDING PERMIT 3� 6�4r'106�6tio` TOWN OF NORTH ANDOVER ° o APPLICATION FOR PLAN EXAMINATION Permit NO:� Date ReceivedArED 4ao � Date Issued: �9SSqCHUS�� IMP TANT:Applicant must complete all items on this page LOCATION G 1 7 I Shg-�2 9 0 ad print PROPERTY OWNER RI Cha e 14- &rrA�u VoV�4 Print MAP NO: PARCEL. ZONING DISTRICT: Historic District yes An Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Res' ential Non- Residential ❑ New Building One family ❑ Addition ❑ Two or more family ❑ Industrial CYAlteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑ Well ❑ Floodplain ❑ Wetlands ❑ Watershed District ❑ Water/Sewer U 42, G l re S f�rM'7 W P ✓l.�O u9 S Identification Please Type or Print Clearly) OWNER: Name: t�� L�[ 1 - �� �va,r•o Phone: Address: i d pL g� CONTRACTOR Name: ,- Phone: �gr rl S rZ�/ Address: I 15- Supervisor's Construction License: Exp. Date: 5a �-rs Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $2 d FEE: $ Q Check No.: Receipt No.: ' NOTE: Persons contracting with unregistered contractors do not have access tot uaranty fund Signature of Agent/Owner Signature of contractoreL,�//4j, 'C' �•� 1 Location • No. L j Date . • TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $` • Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check#14—j Building Inspector 4 NORTH Town of t E . It ndo' ver No. * ` oth ver, Mass, A_ COC MICA WICK �� J�ADR�ttED P�P,�'�5 S u BOARD OF HEALTH PERMI-T L D Food/Kitchen Septic System THIS CERTIFIES THAT ....... BUILDING INSPECTOR has permission to erect buildings onc�_ .�. L f.. .... Foundation Rough to be occupied as ............ ...M..... �I��fi/7/4 ......................................................................... Chimney provided that the person a cepting this permit shall in every respect conform to the terms of the application Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONVS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO S A Rough Service ..... .............................................. Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. a DESS - S _ FIS r[ImIy f�t p ... .. .(� ��I7I ......�.J (� Sao. g R gyp �} �? _ . 91d �� �✓-'PQo3Pd�y� Vt 6h be e�!�i�tt5l�1 er7 CJD M. G. L. be �Efp b'ybe ��p E3 ��J��1-Sc0�6p F.t'; ding Gib G� °umber Esi� We d'abris Pasulfing�P�m h- ���s�Sh�Z9 a dsosad z n �� o q � .�� peg =P: .Cpcaras� as o �� tit as dafmdd.by!v9e 0e L.C. l l I p Sano e o . d �al�P e y pp E ytdp a QtyPosed at. =tl�iu�" rown a Mb NoFthMdo G&'h . a �P� � . RaeS .���0� ��� ��d e of Pormft PaIC � A qlmmm Firm Noma. SIF&s : Sale o FAA 01970 Stege, ,p coda , Aug 18 14 02:21 p The Insurance Advisory 781 4493 51 1 p.1 '4� CERTIFICATE OF LIABILITY INSURANCE DATE,M a 18 a,14 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: The John M.Sullivan Insurance Agen PHONE -449-9330 FAX 781-44.9-3511 P.O.Box 920047 A(c,No•Extl: INC No): Needham,MA 02492 ADDRESS: sullivan.insadv@verizon.net INSURERS AFFORDING COVERAGE NAIC e rNsURERA: The Travelers Indemnity Co 11347 INSURED INSURERS: A&A Services, Inc INSURERS: Street Sal INSURERD: Salemm,, M MA 01970 INSURER INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDE SMBR MUCY EFF POLICY EXP LTR TYPE OF INSURANCE WVoPOLICY NUMBER MMID MMIDDlYYYY LIMITS GENERAL LIABILITY ' EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY UAMALt IU Nth i Lu PREMISES Ea occurrence) $ _f CLAIMS-MADE C OCCUR MED EXP(Any one person) $. [PERSONAL&ACV INJURY S GENERA--AGGREGATE $ GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS-CCMPIOPAGG 5 POLICY ED PRO- 171 LOC i S AUTOMOBILE LIABILITY I - COMBINED SINGLE LIMIT Ea accident; $ ANY AUTO BODILY INJURY(Per parson) S ALL OSCHEDULED AUUTOSS AUTOS BODILY INJURY(Per aocident) S HIRED AUTOS AUTOS ADAMAGE PROPERTY AUTOS S _(Per acrJden[) S UMBRELLA LIAR OCCUR EACH OCCURRENCE EXCESS LIAB S CL0.1MS-MADEI AGGREGATE S OED RETENTIONS S WORKERS COMPENSATION tiVCSTATLL DTH- AND EMPLOYERS'LIABILITY A OFFICERWEMBER EXCLUDED?ECUANY YIN❑ NIA 6KUB-0243M81-5-13 9!1312013 9/13/2014 T R (Mandatory in NH) E.L.EACH ACCIDENT 8 500,000 If yes,describe under E-L.DISEASE-EA EMPLOYEE 8 500.000 DESCRIPTION OF OPERATIONS below EL.DISEASE-POLICY LIMIT $ 5017)000 DESCRIPTION OF OPERATIONS 1 LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,irmore space is requlredl CERTIFICATE HOLDER CANCELLATION Town of North Andover SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1600 Osgood Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN North Andover, MA 01845 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENT ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts Print Form Department of Industrial Accidents Office of Investigations Uly 1 Congress Street, Suite 100 Boston,MA 02114-2017 www mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): A&A Services,Inc. Address: 115 North Street City/State/Zip: Salem, MA 01970 Phone#: (978) 741-0424 Are you an employer?Check the appropriate box: Type of project(required): 1.2 I am a employer with 9 4. ❑ I am a general contractor and I 6. ❑ New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑✓ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance. required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. *Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Travelers Policy#or Self-ins.Lic.#: 0243M815 Expiration Date: 9/13/14 Job Site Address: 27 Silsbee Road City/State/Zip:No. Andover MA 01845 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify un er a ains qAd enalties ofperjug that the in ormation provided above is true and correct Si nature: ( - Datef- r c3 Phone#: (978) 741-0424 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: f `rt\ THE COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF LABOR AND WORKFORCE DEVELOPMENT DEPARTMENT OF LABOR STANDARDS \ ';;; 19 STANIFORD STREET,BOSTON,MASSACHUSETTS 02114 DELEADER CONTRACTOR LICENSE A & A SERVICES, INC. 115 NORTH STREET SALEM MA 01970 LICENSE: DC000440 EXPIRES: Sunday,June 07,201 i IN ACCORDANCE WITH IVLG.L. CH. I 11, S 19713(b) AND 454 CMR 22.03,THIS LICENSE IS ISSUED BY THE DEPARTMENT OF LABOR STANDARDS TO THE CONTRACTOR ABOVE FOR THE PURPOSE OF ENTERING INTO OR ENGAGING IN DELEADING WORK. THIS LICENSE IS VALID FOR A PERIOD OF ONE YEAR. THIS LICENSE MUST BE MAINTAINED BY THE CONTRACTOR WHEN ENGAGED IN DELEADING y WORK IN ACCORDANCE WITH M.G.L. CH. 1 I I § 19713(b)(2)AND 454 CMR 22.03. f HEATHER E. RowE, DIREC op, t,rrn;rrr rrn,rvr�/�r� l�r...;rrr�rr.; /% 1�! Massachusetts - Department of Public Safety Off-ice of Consumer Affairs&Business Regulation ti -, `--'' Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Construction Suhcr�i,ur t ,Registration: 101609 Type: 6/26/2016 License: CS-057733 Expiration: A&A SERVICES, INC CHRISTOPHER ZORZY 115 NORTH ST Christopher Zorzy Salem NIA 01970 115 North Street Salem, MA 01970 Undersecretary I �+ � � R. Expiration Commissionar 05/26/2015 ,�,.. y.. Christopher Zorzy #20120426000840 A&A Services Inc Exp 26/2017 115 North St Salem. MA 01970 � mr=` A & A SERVICES, INC. A /�l�� 115 NORTH STREET, SALEM, MA 01970 Telephone:(978) 741-0424 Fax: (978) 741-2012 Contractor Registration No. 101609 Federal EIN: 04-3090162 Construction Supervisor No.CS057733 CUSTOM REMODELING AND IMPROVEMENT AGREEMENT Bu er s Name Date of Contract MKr t /39/ 7 L f�CWo B—ntS—/ eu er s Street Address,City,State and Zip Code Z S'l�-� ��s R � m2Tk1 �x�o✓�'�2 � O I S Daytime Telephone Number Evening Telephone Number Mobile Telephone Number E-Mail Address atZ,rT?L1 The Buyer(s)listed above hereby jointly and severally agree to purchase the goods and/or services listed on the accompanying specification sheets,in accordance with the prices and terms described on the front and the reverse of this agreement and any specification sheets(this"Agreement"),and Buyer(s)have requested that such goods or services be installed or provided at Buyer's address listed above.A&A Services,Inc.("Contractor"),hereby agrees to install or cause to be installed the products or services listed in this Agreement at the Buyer(s)address written above.This Agreement represents a cash sale of goods and services.The Buyer(s) agree to pay in cash the cost of the goods and services purchased as described herein,regardless of timing or approval of any financing Buyer(s)may seek for their purchase. Q Purchase Price: 2 gG Est.Starting Date: �s / Q �- Down Payment: ��r Est.Completion Date: 30 0 Cash Amount Due on Start of Job: 0 Check Amount Due on Credit Card of Completion: Na W y7 Z p 2/6 S(12—q'17 Amount Due on of Completion: 12-17 Expiration Date:` Balance Due on Upon Completion CVC Code: 1 5- It is agreed and understood by and between the parties that this Agreement, front and back and any addendum, constitute the entire understanding between the parties,and there are no verbal understandings changing or modifying any of the terms of this Agreement.Buyer(s) hereby acknowledge that Buyer(s)has read the front and the reverse of this agreement and has received a completed,signed and dated copy of this Agreement,including the two attached Notice of Cancellation forms,on the date first written above.Buyer(s)also(i)acknowledge that they were orally informed of their right to cancel this transaction;and(ii)request that they be contacted via their telephone numbers or email,as listed above,in the event Contractor believes Buyer(s)would be interested in any additional quality products or services of Contractor.DO NOT SIGN THIS CONTRACT IF IT CONTAINS ANY BLANK SPACES. A&A S rvi s, n✓r Buyer(s) By. Signature SSiignature rt Print Name v " Print Name ^ - - Signature Print Name You,the Buyer(s), may cancel this transaction at any time prior to midnight of the third business day after the date of this transaction. See the following Notice of Cancellation form for an explanation of this right. ARBITRATION:The contractor and the homeowner hereby mutually agree in advance that in the event either parry has a dispute concerning this contract,either parry may submit such dispute to a private arbitration service which has been approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulations and the other party shall be required to submit to such arbitration as proved in MAL c.142A. Cnnvac/ln�in'tials: Boyar's]nihiaL:)( Data: NOTICE OF CANCELLATION / NOTICE OF CANCELLATION Date of Transaaionf/�,You may cancel this transaction,without any penalty or Dale of Transaction v'IS'' .You may cancel this transaction,without an obligation,within three business days from the above date.If you cancel,any pro y penalty or perty haled ed obligation,within three business days from the above date.If you cancel,any property baled ed any payments made by you under the Contract or Sale,and any negotiable instrument executed any payments made by you under the Contract or Sale,and any negotiable instrument executed by you will be retuned within 10 days following receipt by the Seller of your cancellation notice, by you will be returned within 10 days following receipt by the Seller of your cancellation notice, and any security interest arising out of the transaction will be cancelled.If you cancel,you must and any security interest arising out of the transaction will be cancelled.If you cancel,you most make available to the Seller at your residence,and substantially in as good condition as when make available to the Seller at your residence,and substantially in as good condition as when received,any goads delivered to you under this Contract or Sale;or you may,if you wish.comply received,any goods delivered to you under this Contract or Sale;or you may,if you wish,comply with the instructions of the Seller regarding the return shipment of the goods at the Seller's with the instructions of the Seller regarding the return shipment of the goods at the Seller's expense and risk.If you do make the goods available to the Seller and the Seller does not pick expense and risk.If you do make the goods available to the Seller and the Seller does not pick them up within 20 days of the date of your Notice of Cancellation,you ahoy retain or dispose of the them up within 20 days of the date of your Notice of Cancellation,you may retain or dispose of goods without any further obligation.If you fail to make the goods available to the Seller,or if you the goods without any further obligation.If you fail to make the goods available to the Seller,or it agree to return the goods to the Seller and fail to do so,then you remain liable for performance of you agree to return the goods to the Sellerand fail to do so,then you remain liablefor performance all obligations under the Contract.To cancel this transaction,,nail or deliver a signed and dated of all obligations under the Contract.To cancel this transaction,mail or deliver a signed and dated copy of the cancellation notice or any other written notice,or send a tele ram,to Services, copy of the cancellation notice or any 1111,written notice,or send a telegram,to A&A Services, 115 North Street,Salem MA 01970,NOT LATER THAN MIDNIGHT OF &— 115 North Street,Salem MA 01970,NOT LATER THAN MIDNIGHT OFi (y north rnalah 1 HEREBY CANCEL THIS TRANSACTION I HEREBY CANCEL THIS TRANSACTION Consumer's Signature Date: Consumer's Signature Date: �+ A Grade.,re Si....... A & A SERVICES, INC. A&ASERVICES 115 NORTH STREET,SALEM,MA 01970 • Kg' ' • Telephone:(978)741-0424 Fax:(978)741-2012 Contractor Registration No. 101609 Federal EIN:04-3090162 Construction Supervisor No.CS057733 WINDOWS AND STORM PRODUCT SPECIFICATION SHEET Buyer(s)Name Date of Contract 441 K C-7 t 62/7TivCJy 80/vo Buyer(s)Street Address,City,State and Zip Code 7-7 a&-e- 1215 ItlO?z4-?-�- A7vDovI'liq aj8 Daytime Telephone Number Evening Telephone Number Mobile Telephone Number E-Mail Address /307TAJEyr60AJO(RyJ9 The Buyer(s)listed above hereby jointly and several) agree to purchase the goods and/or services listed below,in accordance with the prices and terms described on �� Y1 Y Y 9 P this Specification sheet and the front and the reverse of the accompanying CUSTOM REMODELING AND IMPROVEMENT AGREEMENT,of which this Specification Sheet is a part. WINDOW REPLACEMENT 0 Remove and dispose of# Z— existin wi ows. Install # new V& CESS/ C. windows: ginyl t Wood (Manu acturer) Options: Style Grid pattern NO/V LS Color Interior RIH-` / Color //E�xterior W#1 7Zs Glass Type f Wrap exterior trim with aluminum: Style L--/�L-'n/d� Color 4(IVI a� V All windows will be installed according to the installation procedures in the portfolio. Of Caulk all interior and exterior edges. 0 Insulate where possible around new units. " b/4 Insulate window weight pockets if exist,and around new window units where possible. f Included in this proposal are set up,clean up,Hepa vacuum and cleaning windows inside and out. Building permit included. BAY/BOWS/CASEMENT UNITS/ANY FULL CONSTRUCTION WINDOWS t Create new window opening by cutting through existing home and framing in opening. t Remove and dispose of existing unit(s)in its entirety. Note:Electric and plumbing may exist in wall and will require additional costs to customer if need to be dealt with. f Install window(s)into opening(s). Note: If Bay or Bow installation to include cable support system,new roof system(matching color as close as possible) or tie into existing soffit system. f Bay t Bow f Casement f Other window(s)to include new interior style trim and new exterior style trim and head flashing as needed. Note: Painting and staining not included. STORM PRODUCTS 0 Remove and dispose of# Z existing storm window(/s)). Install new storm windows# _L Manufacturer 1�'ffLV Lam( Style Color Option t Remove and dispose of# existing storm door(s). t Install new storm doors# Manufacturer Style Color Type: f Aluminum t Solid Core SPECIAL INSTRUCTIONS: /A/S ryl-?tel �y ) �z S/L-C- /51`5 All 7V ZK JCQ L(/1'h�L-�2_ /�ytiyj (iL/!'Lt�)p fi✓! '� /f"Lf/I"'l t niyr't C[77[_ S"'aQ.ia'- It is agreed and understood by and between the parties that this Specification Sheet,along with CUSTOM REMODELING AND IMPROVEMENT AGREEMENT,constitutes the entire understanding between the parties,and there are no verbal understandings changing or modifying any of the terms.This contract may not be changed or its terms modified or varied in any way unless such changes are in writing and signed by both the Buyer(s)and the Contractor. Buyer(s)hereby acknowledge that Buyer(s) has read this Specification Sheet. -ts-r Y k87S Contractor Initials: �] Date: Buyer's Initials:_�C��_ Date: